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Stool DNA Testing and Colon Cancer Prevention: Another Step Forward

Daniel C. Chung, MD
[+] Article, Author, and Disclosure Information

From Massachusetts General Hospital, Boston, MA 02114.

Potential Financial Conflicts of Interest:Grants received: D.C. Chung (EXACT Sciences, 2001–2003).

Requests for Single Reprints: Daniel C. Chung, MD, Gastrointestinal Unit and Cancer Center, GRJ 825, Massachusetts General Hospital, 50 Blossom Street, Boston, MA 02114; e-mail, dchung@partners.org.

Ann Intern Med. 2008;149(7):509-510. doi:10.7326/0003-4819-149-7-200810070-00013
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Despite the recognition that colon cancer is largely preventable, it remains the second leading cause of cancer-related deaths in the United States. Historically, screening approaches have sought to detect established cancer, but the identification of precancerous adenomatous polyps is clearly the preferable goal. Not all adenomas progress to cancer, but those that are larger than 1 cm or contain villous histology or high-grade dysplasia are most likely to do so. The current multisociety guidelines now emphasize detection of precancerous polyps as the most effective strategy to prevent deaths from colon cancer, and structural examinations, such as colonoscopy, are recommended for this purpose (1). Testing for occult blood in stool is notoriously insensitive for detecting adenomas (2).

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